Respess v. Travelers Cas. & Sur. Co. of Am.

• Decision Date: 15 March 2011
• Docket Number: Civil Action No.: ELH–10–2937.
• Citation: 770 F.Supp.2d 751
• Court: U.S. District Court — District of Massachusetts
• Parties: James RESPESS, Individually and as Personal Representative of the Estate of Patricia Respess, Plaintiffs,v.TRAVELERS CASUALTY & SURETY COMPANY OF AMERICA, et al., Defendants.

770 F.Supp.2d 751

James RESPESS, Individually and as Personal Representative of the Estate of Patricia Respess, Plaintiffs,

v.TRAVELERS CASUALTY & SURETY COMPANY OF AMERICA, et al., Defendants.

Civil Action No.: ELH–10–2937.

United States District Court, D. Maryland.

March 15, 2011.

Shireen Jayatilaka, Michael John Winkelman, McCarthy and Winkelman LLP, Bowie, MD, for Plaintiff.Michael P. O'Day, Neil J. Dilloff, DLA Piper U.S. LLP, Baltimore, MD, for Defendants.

AMENDED MEMORANDUM OPINION ¹

ELLEN LIPTON HOLLANDER, District Judge.

Patricia Respess committed suicide in 2008. As a result of Ms. Respess's death, her husband, James Respess, individually and as personal representative of the Estate of Patricia Respess, Plaintiffs, filed suit against Travelers Casualty & Surety Company of America and The Travelers Indemnity Company of America (collectively, “Insurers” or “Defendants”), alleging claims for intentional infliction of emotional distress (Count One); gross negligence (Count Two); and wrongful death (Count Three), based on the Insurers' refusal to authorize 24–hour supervised care for Ms. Respess. ² Mr. Respess contends that because Defendants refused to authorize the 24–hour supervised care that Ms. Respess needed, she ingested an overdose of her blood pressure medication on May 5, 2008, and died four days later, on May 9, 2008. See Compl. (ECF 2) ¶¶ 10, 35.

The suit is rooted in an incident that occurred in 1987, when Ms. Respess was physically and sexually assaulted while working for National Medical Care, Inc. (“NMC”). Id. ¶ 7. As a result of the incident, Ms. Respess suffered numerous psychiatric conditions, for which she obtained workers' compensation benefits. Id. ¶ 8. Defendants are the insurance companies that insured NMC with respect to the workers' compensation benefits provided to Ms. Respess. They have moved to dismiss the Complaint, pursuant to Fed.R.Civ.P. 12(b)(6), claiming it fails to state a claim.

The issues have been fully briefed, and no hearing is necessary to resolve this matter. See Local Rule 105.6. For the reasons set forth below, the Court shall grant the Defendants' Motion to Dismiss the Complaint, without prejudice, and shall grant Plaintiffs 20 days leave to amend.

FACTUAL BACKGROUND

As noted, Ms. Respess was physically and sexually assaulted in 1987, while at work. Compl. ¶ 7. As a result of the incident, she suffered from various psychiatric conditions, including Post Traumatic Stress Disorder (“PTSD”), major depressive disorder with severe and recurrent psychotic symptoms, conversion disorder, dissociative identity disorder, and personality disorder. Id. ¶ 8. Ms. Respess “began receiving treatment for these in approximately 1999 to 2000.” ³ Id. ¶¶ 9, 10. From the outset of Ms. Respess's treatment until her death in 2008, the Insurers “approved and paid” her medical expenses, “pursuant to a worker's compensation claim.” Id. ¶ 10.

On or about January 2, 2008, Ms. Respess was admitted to the Mental Health Facility at Peninsula Regional Medical Center in Salisbury, Maryland for “depression, anxiety and flashbacks.” Id. ¶ 12. She was transferred to the “Trauma Disorders Program at Sheppard Pratt,” as an in-patient, on January 23, 2008, and remained there until her discharge on April 25, 2008. Id. ¶¶ 12, 13, 16.⁴ Upon discharge, Ms. Respess returned to her home. Id. ¶¶ 14, 19.

During the weeks preceding her discharge from Sheppard Pratt, Ms. Respess “experience[d] flashbacks,” and told her physicians and counselors of her fear of discharge and her suicidal thoughts. Id. ¶¶ 15, 16. On April 11, 2008, while still hospitalized, Ms. Respess expressed difficulty in “finding a ‘treatment team’ ” near her Eastern Shore residence. Id. ¶ 17. On April 21, 2008, she told her physicians and counselors that “she was discouraged because she did not feel that any outpatient medical providers would give her the care that she needed.” Id. ¶ 18. In addition, two weeks prior to his wife's discharge, Mr. Respess asked Sheppard Pratt counselors to place his wife in a step-down facility, in lieu of a discharge without any supervision. ⁵ Id. ¶ 20.

Five days after Ms. Respess's discharge, Rebecca Rementer, a home health care nurse, visited Ms. Respess to assess her progress. Id. ¶ 21.⁶ Ms. Rementer determined that Ms. Respess had fallen several times since her discharge; was anxious and depressed; and was experiencing paranoid hallucinations as well as recurrent suicidal thoughts. Id. ¶¶ 22, 25. Ms. Rementer learned from Ms. Respess's medical history that, in the past, Ms. Respess had attempted suicide by overdosing. Id. After Ms. Respess disclosed to Ms. Rementer that she had “accidentally” taken double doses of her medications two nights earlier, Ms. Rementer concluded that Ms. Respess was practicing unsafe medication management. Id. ¶¶ 22, 23.

In Ms. Rementer's view, Ms. Respess's “prognosis was poor.” Id. ¶ 26. Moreover, Ms. Rementer believed that Ms. Respess urgently needed 24–hour supervision and, if psychiatric assistance were not provided, Ms. Respess would further decline. Id. ¶ 26. Accordingly, Ms. Rementer called the Defendants, advising of Ms. Respess's suicidal thoughts, and stating that Ms. Respess needed 24–hour supervised care.⁷ Id. ¶ 27. Nevertheless, the Defendants “refused to authorize the needed treatment.” Id.

Thereafter, Ms. Rementer enlisted the assistance of Martin Book, M.D., a psychiatrist who had previously treated Ms. Respess. Id. ¶ 28. Dr. Book called the Defendants and requested “immediate” 24–hour supervised care for Ms. Respess.⁸ Id. However, Defendants again refused to authorize 24–hour supervised care, “even though [they] were aware that Ms. Respess' psychiatric condition had declined since her discharge from Sheppard Pratt 5 days earlier,” and knew of her “long history” of psychiatric illness. Id. ¶ 29.

Ms. Respess's condition continued to decline. Id. ¶ 30. On or about May 4, 2008, Mr. Respess wrote a letter to Sheppard Pratt expressing his concern regarding his wife's declining health, and requesting that she be placed in a residential setting with 24–hour supervision. Id. ¶ 31.⁹ Defendants stated that, although Ms. Respess's psychiatrist had diagnosed her with PTSD, “they did not believe that [she] actually suffered from PTSD....” Id. ¶ 32. ¹⁰ On May 5, 2008, Ms. Respess wrote a suicide note stating that “she did not have any fight in her to challenge the Defendants anymore....” Id. ¶ 34. On that date, she took an overdose of her blood pressure medication, fell into a coma, and died four days later, on May 9, 2008. Id. ¶¶ 10, 34, 35.

STANDARD OF REVIEW

As noted, Defendants have moved to dismiss the Complaint, pursuant to Fed.R.Civ.P. 12(b)(6), alleging that it fails to state a claim. Such a motion tests the sufficiency of the Complaint. See Edwards v. City of Goldsboro, 178 F.3d 231, 243 (4th Cir.1999).

Under Fed.R.Civ.P. 8(a)(2), a complaint must contain a “short and plain statement of the claim showing that the pleader is entitled to relief.” See Swierkiewicz v. Sorema N.A., 534 U.S. 506, 513, 122 S.Ct. 992, 152 L.Ed.2d 1 (2002). The purpose of the rule is to provide the defendant with “fair notice” of the claim. Erickson v. Pardus, 551 U.S. 89, 93, 127 S.Ct. 2197, 167 L.Ed.2d 1081 (2007). To that end, Rule 8(a)(2) “requires a ‘showing,’ rather than a blanket assertion, of entitlement to relief.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 n. 3, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007). The showing must consist of more than “naked assertion[s] devoid of further factual enhancement.” Ashcroft v. Iqbal, ––– U.S. ––––, 129 S.Ct. 1937, 1949, 173 L.Ed.2d 868 (2009) (internal citations omitted). “Threadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice.” Id. at 1940; see Twombly, 550 U.S. at 555, 127 S.Ct. 1955 (the “plaintiff's obligation to provide the ‘grounds' of his ‘entitle[ment] to relief’ requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do”).

Dismissal is mandated if the complaint does not allege “enough facts to state a claim to relief that is plausible on its face.” Twombly, 550 U.S. at 570, 127 S.Ct. 1955. See Simmons v. United Mort. and Loan Inv., LLC, 634 F.3d 754, 768, 2011 WL 184356, at *10 (4th Cir. Jan. 21, 2011); Andrew v. Clark, 561 F.3d 261, 266 (4th Cir.2009). In “determining whether a complaint states a plausible claim for relief ... the reviewing court [must] draw on its judicial experience and common sense.” Iqbal, 129 S.Ct. at 1950. The Supreme Court said in Iqbal, 129 S.Ct. at 1949: “A claim has facial plausibility when the pleaded factual content allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” See also Twombly, 550 U.S. at 556, 127 S.Ct. 1955. But, “ ‘the court need not accept the legal conclusions drawn from the facts, and need not accept as true unwarranted inferences, unreasonable conclusions, or arguments.’ ” Simmons, 634 F.3d at 768, 2011 WL 184356, at *10 (quoting Monroe v. City of Charlottesville, Va., 579 F.3d 380, 385–86 (4th Cir.2009)) (quotation marks and alteration marks omitted in Simmons ).

Nevertheless, “The issue is not whether the plaintiff will ultimately prevail, but whether the plaintiff is entitled to offer evidence to support his or her claims.” Scheuer v. Rhodes, 416 U.S. 232, 236, 94 S.Ct. 1683, 40 L.Ed.2d 90 (1974), overruled on other grounds, 468 U.S. 183, 104 S.Ct. 3012, 82 L.Ed.2d 139 (1984). Moreover, given the posture of this case, the Court must “accept the well-pled allegations of the complaint as true,” and “construe facts and reasonable inferences derived therefrom in the light most favorable to the plaintiff.” Ibarra v. United States, 120 F.3d 472, 474 (4th Cir.1997); see also Bass v. E.I. DuPont de Nemours & Co., 324 F.3d 761, 764 (4th Cir.2003).

DISCUSSION

I. Count One: Intentional Infliction of...